After testing and treating close to a million men for low testosterone, Dr. Haleem Mohammed said he’s noticed a pattern: Symptoms often get attributed to one condition when it may belong to a different one — or to both at once.
Mohammed is the chief medical officer of Gameday Men’s Health, a chain of more than 400 clinics that treat low testosterone in the U.S. and Canada. A number of the symptoms of low testosterone “overlap with PTSD and depression,” Mohammed said.
Same List of Symptoms, Two Possible Causes
Mohammed described low testosterone in veterans as showing up through:
- Belly fat that persists despite hard training
- A shorter temper
- A flat or tanked mood
- Brain fog
- A drop in sex drive
Each of those also appears on standard lists of PTSD symptoms, which commonly include:
- Irritability
- Difficulty concentrating
- Emotional numbness
- Disrupted sleep
“A lot of guys chalk it up to age or the job, but it’s actually their hormones,” Mohammed said.
Mohammed said the overlap runs deeper than two conditions that happen to share a few symptoms. Irritability in particular, he said, cuts against a common assumption about testosterone.
“That idea of ‘roid rage — the opposite actually happens, too, where low testosterone makes someone more irritable,” he said. That means a veteran already prone to irritability as part of a PTSD diagnosis has little reason to suspect a hormone problem underneath a symptom his diagnosis already explains.
Related: VA Drug for Treatment-Resistant Depression Requires Up to 50 Visits a Year
What the Research Shows
The link between testosterone and PTSD symptoms has drawn growing research attention beyond Mohammed’s clinical observations. A 2025 study published in the journal Translational Psychiatry, analyzing more than 130,000 UK Biobank participants, found a U-shaped relationship between testosterone levels and future PTSD symptoms in both men and women: Symptom scores were lowest at mid-range testosterone levels and rose at both the low and high ends of the scale, with the association strongest among participants with a higher body mass index. The study drew on a general civilian population rather than veterans, but its authors described it as the largest analysis of the relationship to date.
A separate case report published in the American Journal of Psychiatry documented a 29-year-old Marine veteran with PTSD and a history of blast-related concussions who was found to have severely low testosterone tied to pituitary damage from his injuries. After starting testosterone treatment, the veteran’s sleep, concentration and energy improved, and clinicians noted his irritability and explosiveness eased into what they described as a sense of calm. The report involved a single patient rather than a broader trial, but it illustrates the mechanism Mohammed described: A physical injury common in combat can suppress testosterone in a way that produces symptoms nearly identical to PTSD.
Where the Overlap Starts, Physically
Mohammed pointed to blast exposure and head injuries as a direct physical link between combat and low testosterone, since trauma to the pituitary gland can impair the signal that tells the testes to produce the hormone in the first place. He also cited sleep loss, sustained training on limited calories and sleep apnea as contributing factors common to military service. “There were studies out of Ranger School that showed testosterone levels falling to what you’d see in much older men during the course of training,” he said.
That combination, Mohammed said, means veterans can develop low testosterone through the same experiences — deployments, blast exposure, chronic sleep disruption — that also put them at risk for PTSD, without either condition being ruled out or in.
Related: After 25 Years Without a New PTSD Drug, Here’s What’s in the Pipeline
Why That Matters for Treatment
Mohammed said the distinction is not academic. A veteran treated only for PTSD, without a hormone panel, could be missing a physical cause that responds to a different kind of treatment. A veteran treated for low testosterone without addressing trauma could see hormone levels improve while the underlying condition goes unaddressed.
“They may be putting on belly fat even though they’re training hard,” Mohammed said, describing how metabolically active fat tied to low testosterone can compound the fatigue and low mood a veteran may already be attributing to PTSD alone.
Mohammed said the fix starts with a lab test rather than a guess. Diagnosing low testosterone requires both a blood level below 300 nanograms per deciliter and a matching set of symptoms, confirmed on more than one morning draw because testosterone is highest early in the day.
Roughly half of the men who come through his clinics for low testosterone, he said, turn out to have reversible causes — excess weight, poor sleep, stress — that resolve without a prescription once addressed and retested months later.
What a Veteran Should Ask For
Mohammed said a veteran experiencing fatigue, low mood, irritability or brain fog — with or without a PTSD diagnosis — should ask a provider for a testosterone panel alongside any mental health evaluation, rather than assuming one diagnosis explains everything.
“If they’re skeptical, I’d want them to know this is something normal we’re seeing, and we’re seeing it at younger ages,” Mohammed said. “There are things we can help with before jumping to a prescription. Getting tested isn’t a stigma.”
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